Diabetes and Anxiety – Part 2: The Connection

In my last post, I told you my story about my own experience with anxiety.  Today I want to explain the role that I feel diabetes has played in this experience.

(On a side note, I am writing this while home sick with some sort of stomach bug – or something resembling some sort of stomach bug.  If you read my last post, you’ll hopefully realize the irony in this.)

Without having the specific stats to give you, studies show that there is a correlation between diabetes and issues such as anxiety and depression.  Maybe there’s some genetic component to this correlation, but in my non-scientific opinion, there is definitely a conditioned component.  

It comes down to this:  Life with diabetes is stressful. 

With all due respect to everyone else, if you don’t have diabetes or live with someone who does, you truly have no idea.

I have spent my whole life worrying – sometimes more and sometimes less, but rarely not at all.  The normal child/teenager/adult worries and stresses have been there too, but I have also been continually surrounded by this additional layer of diabetes-related worries and stresses:

  • Will my bloodsugar go too low without my noticing?  Will I pass out?
  • Will my bloodsugar go too high? 
  • Will people think I’m different?
  • Will there be food there that I can eat?
  • Will I be able to eat when I need to?
  • Will I have to sit out something I want to do because of my bloodsugar?
  • Will I get sick and not be able to manage my bloodsugar?  Will I have to go to the hospital? 
  • Can I afford all the treatments (i.e. glucose sensors, insulin pump) that I need to manage my diabetes as best as I can, but that my insurance won’t pay for.
  • Will I have complications later in life? 
  • Am I doing everything I can to take care of myself?
  • Why does it feel like I’m doing this all wrong?
  • Why can’t I figure out a solution that works consistently?
  • Will I go low at night and not wake up?
  • Will I go low while I’m driving and, heaven forbid, cause an accident?
  • How many carbs does that have?
  • How fast will that food raise my bloodsugar?  How much?
  • How fast will that activity drop my bloodsugar?  How much?
  • Is my insulin pump infusion site still working?
  • If my pump stops working, what will I do?
  • Do I have all of my supplies along?  Am I prepared if I pull out my infusion site by accident?  Do I have an extra pump battery on hand?
  • Will they let me through airport security with all this medical paraphanalia?
  • What will I do with my pump at the beach when I want to go in the water?
  • Did I overtreat?
  • Did I undertreat?
  • Is there too much scar tissue in this infusion site?  Do I need to rotate sites?
  • Will I wake up with an occlusion, high bloodsugar, and DKA?
  • Will I feel my bloodsugar rise or drop if I have another drink?
  • Will I miss too much school or work because of doctors’ appointments?
  • Will I run out of supplies and not be able to test my bloodsugar or take insulin?
  • Did I remember to take my insulin?
  • Why do I keep forgetting to take my insulin?!
  • Why do I crave the foods I shouldn’t be eating?  Why can’t I eat what I want to when I want to?
  • Will I be able to fit all of my supplies in this purse?
  • Will my insulin pump look stupid with this outfit?  Can I make it work with this dress?
  • Will my CGMS transmitter show through this shirt?
  • Do people notice my pincushion fingertips?
  • Will I be able to have a baby?  Will I be able to manage a pregnancy?
  • Will I be able to have a second baby?
  • Will my child/children ever be at risk because of my low bloodsugar?
  • Will my child/children develop diabetes?  Will it be my fault if they do?  Will I be able to handle that?
  • Will my eyes bleed again?  Will I go blind?  Will I see my daughter grow up and have a daughter of her own?
  • Will my kidneys fail?
  • Will my life be cut short…?
  • Why do I never get a break from this….?

That’s a lot to worry about. 

Of course, a person with diabetes generally isn’t hit with all of these all at the same time, but in my own experience, it’s not too difficult to touch on at least a dozen of the above stresses in a day…in addition to normal daily stress.

Plus, diabetes management in and of itself can take a lot of time and mental energy: counting carbs, testing bloodsugars, balancing insulin levels, taking shots or changing infusion sets, etc.  Not to mention the periodic logging, looking for trends, problem solving, etc.  Some days aren’t bad, but some days it truly feels like a second job.  It takes me away from the task at hand – from my work, my friends, my family – if not in body, at least in focus.  It’s work.  Sometimes a lot of work.

And then there’s the guilt.  For the most part, I don’t think anyone means to make us feel guilty, but I challenge you to try to find someone with diabetes who has not at some point been made to feel diabetes-related-guilt. 

It comes from our doctors and nurses and dieticians: “Your A1C needs to come down.”  “You need to brush up on your carb-counting.”  “You’re running too high overnight.” 

It comes from the people who don’t really know us: “Should you be eating that?” “You must have had too much sugar as a kid.” “Retinopathy?  Tsk, too much cheating, eh?” 

It even comes from our friends and family who really don’t mean it, sometimes in the form of own impressions of the impacts we are having on them: “I shouldn’t have snapped at him when all he was trying to do was open the bottle of Gatorade to fix my low.” “Is my diabetes harming my unborn baby?” “Will I be able to be around for my family as long as I should be…or will this disease steal me from them at some point?”

All of these factors have played a part in who am I today and the demons I struggle with.  But for me, I think the killer has been the extra level of sensitivity that I have needed to have over what is happening to my body – and the extra level of control it makes me feel that I need. 

Over the last almost 30 years, my senses have become finely tuned to any changes in my body that might indicate low or high bloodsugar requiring an intervention from me.  Because of this, any time something is “off” it sets off alarm bells in my mind.  But sometimes it’s just that I ate something that’s disagreeing with me, or that I’m tired, or that I’m stressed, or that I drank too much caffeine….etc.  There are 1000 normal reasons for me to feel “off” and not to be anxious about it, but it’s become very difficult for my mind not to overreact to each and every one of those signals from my body.  It’s hard to filter the “meh, not a big deal” signals out of there.  The result can be a very edgy me.

The extra kick in the teeth for me is that I have a pretty good feeling that I’m also predisposed to anxiety.  I have other family members who struggle (or have struggled) with it, so the genetic component is likely at play.  As well, I’m very analytical and detail-oriented.  So I pick things apart and get caught up in the little things that other people don’t.  When you have diabetes, this can be a blessing and a curse.  In all honesty, I’m not sure how people who aren’t very analytical manage their diabetes, but I bet they do it with a lot less stress than I do! 

So all of this is a part of me, and so is diabetes.  The chicken vs. egg question is unanswered…and probably moot anyway. 

So that’s that.  There’s my anxiety post – times two. 🙂

Lastly, though, I want to comment on the stigma that goes with anxiety, depression and other mental illnesses.  It’s so sad to me that so many people feel that these issues are character flaws and or aspects of oneself to be ashamed of.  It’s easy to hide these pieces of us rather than reach out for help, because it’s scary to admit to having problems like these for fear of what others will think of us.  

It’s easy to feel like struggles like these mean that we’re weak.  But they don’t.  We’re not.  Taking the steps to get help and to help others see anxiety as something not to be ashamed of means that we’re strong. 

Every voice helps.  Don’t hide.  Speak out.

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13 responses to this post.

  1. Posted by Ty on April 20, 2011 at 6:00 pm

    Is there some test somewhere that would tell me how depressed I am? I dont know how to measure if i need help or not. Please dont just tell me to “Ask your doctor/endo”.

    Reply

    • Hi Ty. I don’t know of a test like that to point you towards, I’m sorry. I can’t give you medical advice because I’m not a doctor, but from my own experience I think that issues such as depression or anxiety warrant getting help when they start to interfere with your life. If your depression is keeping you from doing what you want to do, keeping you from enjoying the things you’re doing, or getting in the way of relationships that are (or used to be) important to you, you might want to consider getting some help so that you can enjoy your life more! If it’s not getting in the way, maybe you’re managing well enough on your own.

      That said, I believe that all of us can work to improve our mental health! Ultimately the decision is up to you whether or not that’s something you can, or want to, do on your own – or whether it’s time to seek outside help. You know the answer to that better than your doctor or endo does anyway.

      All the best to you! Thanks for writing. I hope you find the answers you’re looking for.

      Reply

  2. Posted by ty on April 21, 2011 at 12:19 am

    Ok. Thanks. I really enjoy reading your blog and all the struggles you are going thru are about the same as me. Father of 2. Diabetic for 20 years now. Still hoping for the best but preparing for the worst. I have fears and they haunt me a lot, but I still have a loving wife and healthy munchkins to look after. Thanks!

    Reply

    • Thanks Ty! I’m glad you enjoy Me With D!

      If you feel that counselling would help you deal with the fears that are haunting you, then it might be worth your while to seek help. While it might not make the fears go away, you may figure out a way to keep them from haunting you to the degree that they are. Good luck!

      Reply

  3. I have wanted to comment on these posts since you put them up. You and I most certainly have a lot in common. The Diabetes and anxiety/depression, as well as the nausea and fear of vomit. I can’t say I’ve ever met someone who has ever understood my “nausea” before and now I think you actually do! I always knew it was anxiety induced but never knew how to fix it. I could never master the mind over matter thing and inevitably ended up rolling around in discomfort. The occurrences are thankfully farther and fewer between these days. Its always nice to know I’m not alone.

    Reply

  4. Posted by sylvie on May 1, 2011 at 9:04 pm

    Thanks for such a candid sharing of life experiences. I think most of us PWD have in some way, to some degree, experienced the fear, anxiety and/or depression that so often is tied to the betes. It is always comforting to know that others struggle with similar experiences, and some of their ways of dealing with it all. Thanks again.

    Reply

  5. Posted by Fenbeast on May 4, 2011 at 3:44 pm

    …and, of course, with stress and anxiety comes an increase in the stress hormone cortisol. Which makes you more insulin resistant. Just to give you something else to worry about. 🙂

    I feel your pain. I don’t have D myself, but I have a beautiful, smart, charming four-year-old with Type 1 and all those anxieties you have for you, I have for him. (Well, not the ones about him having a baby…) Some nights I look at his sleeping face and wonder if I’ll get to watch him grow up. Will he die in his sleep of a catastrophic low if I’m not right there to pick up on it? (His brand new CGM alleviates that somewhat, but only somewhat). I have learned to stop my brain when it goes down the worry vortex by reminding myself that stress is only going to wreck MY health, and I can’t help him with his if I’m in the psych ward or the ICU. But it doesn’t take the background worry away. I don’t know if that will ever go away.

    Reply

    • I have a huge amount of respect for parents of children with diabetes! I can only imagine the anxiety of caring for someone else’s diabetes. Sounds like you’re doing a great job! He’s lucky to have you!

      Reply

  6. Posted by Sam on May 4, 2011 at 6:15 pm

    Hiya, I just found this whilst browsing other d-blogs and I have to say, I know exactly what you mean…I was recently “diagnosed” with anxiety because of diabetes issues and it is very very tough. Thank you so much for sharing

    Reply

  7. Posted by Susie on May 4, 2011 at 8:02 pm

    Hi Bethany, All of those diabetes related stress questions run through my mind as well! Very well written blog. I am going to try to share this with my friends and family as I don’t believe anyone really understands unless they live it and feel it. Thanks for sharing and good luck! ~Susie

    Reply

  8. Posted by Gaye McKim on May 5, 2011 at 12:32 pm

    Hello Bethany,

    I am a type 2 diabetic I was diagnosed over 18 years ago and I truly relate to what you have been going through. I also blogging about my experiences as a type 2 diabetic and the two different personalities that I have going on inside of me doing battle trying to be healthy vs being unhealthy.

    Thank you so much for sharing your stories with all of us.

    Gaye

    http://bettyvshelena.wordpress.com/

    Reply

  9. Thanks everyone for all of your encouraging comments! Great to hear from you!

    Reply

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